There's no doubt that a complete and comprehensive view of the care a patient has received is essential to providing quality care. However, with challenges such as disparate systems, siloed data and the lack of interoperability, this can be difficult to do today.

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One healthcare organization, Easter Seals Bay Area, with various locations in Northern California that provide services to children with developmental disabilities and special needs with a focus on children who have been diagnosed with autism, is working to remedy that with the help of Salesforce's Health Cloud, which is built on the company's Service Cloud, Joshua Newman, chief medical officer at Salesforce, said.

However, Easter Seals has two added challenges. First, they are focused on behavioral health tech and care for autistic patients. This means information about the patient from multiple providers, ranging from primary care doctors to therapists, must be accessible. Second, they treat most of their patients at home meaning successfully scheduling and coordinating various providers from different organizations is imperative.

Joshua Newman

"As you can imagine, it's a lot of coordination of people that need to go to the home," Robert Van Tuyl, chief innovation officer at Easter Seals Bay Area, said. But it's more than simply scheduling and coordinating a patient's caregivers. It's also making sure that the right caregiver is paired with the right patient. For example, making sure an autistic patient who may be violent is assigned a caregiver qualified to handle that situation, Van Tuyl added.

"So knowing the quality of the person… that will oversee the quality of the care is part of what we do, and making sure that the quality and the logistics, if you will, of the care-team is well-managed," he said.

Robert Van Tuyl

Van Tuyl explained that in the behavioral health space, managing care teams from multiple organizations is complex and it is well known that this hasn't been done very well in the healthcare industry.

"Sometimes when you go from one doctor to another doctor or specialty service, you need to bring your own data and it takes a long time to get your electronic health record to the other provider," Van Tuyl said.

Easter Seals is working to not only effectively coordinate a patient's care but make sure all the relevant information about a patient is within reach of caregivers by utilizing behavioral health tech such as Salesforce's Health Cloud, which is set to go live at Easter Seals August 2016.

Behavioral health tech: Salesforce's Health Cloud

"Health Cloud is a platform that spans across… providers and tries to make the patient relationship something that is more akin to a normal business relationship," Van Tuyl, said.

Health Cloud allows Easter Seals to see who has access to what information about a certain patient and can tweak those permissions accordingly.

"For example, I can't see the full electronic medical record from Kaiser, but I can see the pieces that get pulled into Health Cloud from Kaiser," Van Tuyl said. "On my side, we have the Easter Seals Bay Area electronic medical record that I then provide a full visual to a contractor but not the entire medical record."

Aggregating clinical data

Van Tuyl described the Health Cloud as being akin to Google Drive or Google Photos.

"You can create an album and make it a shared album, and then once you make it a shared album, you can decide if people can add information to it," he said.

Someone from Kaiser can share information about the patient, as can the patient's primary care doctor or therapist, for example.

"So we're getting an ability to aggregate medical record information from the various stakeholders that are working on these cases," Van Tuyl said.

But getting that information out of the EHR can be very difficult, Newman said. He explained that robust APIs, HL7 messages and middleware solutions have helped them solve this problem.

Customized mobile application

Van Tuyl added that another benefit of the Health Cloud is the ability to create a custom mobile application. Easter Seals took advantage of this opportunity and built a charge entry mobile application.

The goal of this application is to capture appointment check-in data and see which provider visited which patient.

Van Tuyl added that Easter Seals has plans to develop another custom mobile application that would capture data on how well patients are meeting goals set out for them by their care team.

Behavioral health information and the cloud

When it comes to the cloud in healthcare, many are wary of its security. And with behavioral health information, there's an added layer of sensitivity.

Laura Young

But some experts say the cloud is no more or less secure than any other technology out there and Laura Young, executive director of the Behavioral Health Information Network of Arizona, agrees.

"We call it the cloud but the application itself is being stored in a data center in some location somewhere in the United States likely," she said. "Even if you have a database that was more locally stored on site … anybody who has a way to get into your system from outside, whether it's through the internet or some other method, could easily hack the data."

That's why Young encourages healthcare organizations to ask cloud vendors questions: "Where is [the data] stored? What kinds of HIPAA audits have you done? ... Is the data center compliant?"

And for healthcare organizations focused on behavioral health tech such as Easter Seals, another requirement that should be looked into is 42 CFR Part 2, which is part of the code of federal regulations that addresses confidentiality when it comes to alcohol and drug abuse.

While Easter Seals doesn't deal with patients suffering from alcohol and drug abuse they still take privacy and security seriously.

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